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Old 09-16-2023, 08:50 AM   #1
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One cataract surgery down and one to go!

Three years ago my optometrist said I was starting to develop cataracts (age 65) but I noticed nothing. Last year she said it was time but my wife was having knee replacement surgery so I deferred the cataract surgery until this year (my wife is now doing great).

I could still drive at night, had no glare problems (that I recognized as a glare problem), and have worn glasses since age 2 or 3. But road signs were blurry with the right eye, even those giant ones on interstates. I could read them with the left eye OK and heck, people with only one eye can get a driver's license.

The big problem last year was the right eye. They put the phoropter (the lens machine) in front of each eye and try to find the best lens for the new prescription. The optometrist went one "click" counterclockwise from my current prescription and the right eye got noticeably worse. She went one click clockwise from my current prescription and the right eye got noticeably worse. Oops...

Last year I failed the Glare Test on my right eye but not on the left eye so traditional Medicare would only pay for the right eye because the left eye was not medically necessary yet. This year both eyes failed the Glare Test.

It definitely was time.

The left eye, the "good" one, was done on Wednesday and the right eye cataract surgery is in two weeks. It easily was the simplest surgery I've ever had and the difference in the vision between the two eyes is stark. (I was very, very apprehensive about any eye surgery and I drove my optometrist and surgeon nuts with my anxiety-induced questions and none of my concerns were reality.)

As everyone said, bright whites, bright blues, etc. I knew I was having intensity issues because I was needing to turn light dimmers full bright but my wife (5 years younger) did not. But I did not think the cataracts were affecting my vision as much as they were because the changes come on very gradually.

In the kitchen the right eye needs full bright. The left eye, the fixed one, needs about 1/2 dimmer for the same intensity.

There is a significant yellowish tint to everything with the right eye, but it used to be with both eyes. I just didn't know.

Looking at a laptop is where I really notice that. The left part of the screen is bright white and the right half is dimmer and yellowish.

Even worse, last month I spent many, many days buffing out oxidation on the motorhome, polishing, and waxing. I thought the motorhome looked darn good now. And it still does, with the right eye. With the fixed left eye? Ugh...

So why was the "good" eye done first? Seems counterintuitive, right?

I'm going with monovision where one eye (left) is set to nearsighted and the other eye (right) is set to farsighted. That lets me read without needing reading glasses. I'm one of the few people in the population where my eyes are naturally that way so this is not a major change for me. But monovision can be a major change for many people and some people just do not adapt.

Yes, the optometrist had to mark my eyeglass prescriptions to assure the eyeglass company caught that one eye is nearsighted and the other farsighted.

When going with monovision my surgeon prefers to do the nearsighted eye first. That allows her to tweak the other eye, the one being set as farsighted, if needed to correct for any defects in the way the nearsighted eye was set.

With the fixed left (nearsighted) eye I now can read the microscopic print on medicine containers without glasses. I have not been able to do that with or without glasses for years. I was using my phone camera as an electronic magnifying glass.

So yeah, much, much better.

The right eye has a lot of astigmatism but due to corneal irregularities I cannot get an astigmatism-correcting toric lense. So that eye's outcome may not be as good and I'll probably still need to wear glasses. My eyes were mapped last year once and twice this year to try to see if an astigmatism-correcting toric lense could be used in the right eye but it's a no-go.

If you've had that mapping and seen the screen you know the eye mapping looks like a weather radar. My left eye was just shades of green. But the right eye, the one with the irregular cornea, looked like a major thunderstorm all three times. Some green, a lot of jagged yellow and a fair amount of jagged red. The surgeon asked if I ever had an eye injury but nope, just bad genetics.

I'll find out in a couple of weeks how that right eye turns out. But it's gotta be a lot better than it currently is.

As for how usable my current eyeglass prescription is, whew. I have progressive lenses so the glasses still help with the right eye somewhat. The glasses do help with the fixed left eye for distance, thankfully, but do cause some blur up close. A new prescription is created one month after the second eye.

Apparently traditional Medicare pays for one pair of glasses after cataract surgery so that's good. I use Costco for glasses but I do not know if they accept Medicare so that free pair may need to come from some place else.

So far so good!

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Old 09-16-2023, 11:40 AM   #2
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Having gone thru lots of surgeries I am moving towards eye surgery with LOTS of apprehension.
I am very comfortable with having to have surgery but EYEBALLS are different.

Reading your post about your adventure helps a little bit......

Glad to hear your left eye went so well. Post back after right eye.
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Old 09-16-2023, 11:59 AM   #3
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OB, I felt the same way about someone messin' with my eyeballs, but it was no problem at all when it was done. The best thing is the immediate results when you are finished. After 63 years wearing glasses it's nice to no longer need them. Doc said I may need reading glasses, but the only glasses I wear now are my shades when I'm out in the sun or my shooting glasses.

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Old 09-16-2023, 12:31 PM   #4
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My right eye was done yesterday. I am still dilated, so outdoors in the sunlight is tough. The left is scheduled to be done about 3 weeks out.
I have chosen to remain nearsighted, since I have been that way since age 12 and want to continue having the protection of auto-shading tinted lenses. Biscuit, the anesthetist will be telling you about what she'll be doing for you and the next thing you know, you will be asked to sit up out of bed and onto a chair. I can only vaguely remember some repeated rinsing of the eye and placement of the sterile operating shield. The scratchiness should dissipate by the following morning. You will be given a scheduled narcotic so there will be no drinking or driving post-op, the day of. Good luck to all!
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Old 09-16-2023, 04:07 PM   #5
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I had both eyes done three years ago. was really simple and easy. No complications whatsoever. I highly recommend doing it as soon as you discover you need it. Your eyes will not improve without the surgery.
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Old 09-16-2023, 04:25 PM   #6
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I had mine done in 2016 2 weeks apart. The Dr has his own surgery suite so no going to the hospital. The 1st eye the anesthesiologist gave me a little too much and I didn't remember a thing. A different anesthesiologist was used for my 2nd eye and I remembered everything. I developed some minor scar tissue in both eyes and had to have a laser procedure to remove it. That was as easy as the cataract surgery. I don't really need glasses but I use a pair (minor correction) when driving at night and use readers if I am reading the paper or a book.
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Old 09-16-2023, 04:25 PM   #7
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The process on surgery day

I left my street clothes on but my shirt was removed and replaced by a gown. I lay on a cot and the headrest is kind of U-shaped to cradle the head to keep it from rolling side to side.

I had a cough and the anesthesiologist said all I had to do was say "STOP" and the team would stop in case I had to cough or sneeze. That did not happen.

While I really, really tense up when anything gets near my eyes that is just part of the pre-op and post-op process so I needed to just deal with it. While on the cot the nurses applied drops to dilate the eye, drops to numb the eye, a few other drops, and then applied some reddish drops. I asked "Wait, did you just pour Betadine on my eye???!!!" and they replied yes, an ophthalmic betadine. Two times. Then they gently scrubbed the area around the eye and poured water on the eye to wash the excess off.

Yes, I had a death grip on the cot railings but it was nowhere near as bad as I feared.

They had me close both my eyes to spread the drops and keep them closed until I was in the OR. Once in the OR they had me open both eyes and confirm which eye was being done. I raised my left hand and said "This one and with a nearsighted lens." which the surgeon confirmed. They marked the area above that eye with an indelible pen. I still have a kind of a tattoo there.

I was told to close my eyes and I could feel and hear a plastic drape being placed on my face. I said "Hey, you didn't tell me I was getting waterboarded." Yeah, I think they've heard that joke before...

I was told to "Look at the light with both eyes and do not go into the light" so obviously they'd heard that joke about 10,000 times.

I was given Versed IV as a calming agent and all I saw was a moving light above my eye. It actually appeared as four lights kind of bobbing around. During the surgery I was told once to look into the light so I had let my gaze drift.

I neither felt nor saw anything except those four bobbing lights. I remember no conversation except for when I was told to look into the light again.

Then I must have been given more Versed or it took more effect and I woke up in Recovery. The whole process was about 10 minutes and the actual surgery was about six minutes. The incision in the side of the eye where the old lens was removed and the new lens was inserted is supposed to be about 2 mm or 1/10th of an inch (phacoemulsification).

I had an oval plastic patch taped over the left eye but I was out when it was applied. The patch has several holes to let light through but it's really a clear plastic patch to block water and dust.

My total time in the surgery center was about 2.5 hours from arrival to departure. I was given a set of sunglasses to wear until the light sensitivity decreased and also to block flying stuff. Those glasses have a top, bottom and sides so they're almost like safety glasses.

My left eye was REALLY bright and that extra perceived brightness did not start to wear off until today. My eyes were no longer dilated as of yesterday so it really is just extra light hitting the retina from the cataract removal.

At the one-day checkup yesterday everything looked great and I was told to start the eye drops. Two drops five minutes apart four times a day. I asked if I needed to wake up at 4 AM and was told "Absolutely not. One set upon waking up, one at lunch, one at dinner, and one before bed is all that's needed."

Now, I really, really have a hard time with anything near my eye like drops. They showed me how to pull the skin a bit and place the drops. By the second day taking the drops is a total non-event. Whew.

Two drops four times a day for two weeks, two drops three times a day for one week, and two drops once a day for one week and I'm done with drops.

I only wear the eye patch while sleeping to keep from accidentally trying to rub the eye, which I did try to do upon wakening the first morning after. I need to wear the eye patch for ten nights. It's no big deal.

I have had no redness, no pain, no itchiness, no scratchy feeling, no draining, nothing. I look at the eye closely when applying drops to assure no redness is developing, which could indicate an infection.

Let's talk about showering. Showering is OK on the day after surgery. You need to keep water and soapy water out of the eye and I was advised to apply the eye patch with the tape, take a shower with my head faced down and that eye GENTLY closed (not firmly closed), and then use the scheduled drops afterwards. Even with the tape around the top and sides of the patch it got damp inside the patch. Not wet but damp on the foam edges.

One cataract surgery site recommended these things for showering and they arrived today so I'll be trying one tonight. It looks like a good solution:

No lifting over 20 pounds for two weeks so no laundry and no carrying the vacuum up or down stairs. No repetitive bending for two weeks so my wife gets to pick up all dog "droppings" for a while. No lawn work. It's kind of like a medically-enforced vacation so far except I did clean the toilets today.

I had no narcotics at all but it took a day for all effects of the Versed to wear off. My vision was much clearer when I woke up the day after surgery.

And yes, I am really looking forward to getting the other eye done now instead of dreading it. Seriously.

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Old 09-16-2023, 04:59 PM   #8
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I also have this procedure to, um, look forward to some time in the next few years, I'm told. Thanks so much to NXR and others who posted their experiences.
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Old 09-16-2023, 05:28 PM   #9
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I have worn glasses for years, and have always kept up with my eye health.

I'm 68 now, and had both of my cataracts removed within a month's time when I was 59. I was a rare case my surgeon said, in that my vision problems came on and advanced very quickly for that age. After the initial detection/diagnosis, within 6 months I could no longer read, or even drive, etc.
That's how fast my vision deteriorated. Where for most people it takes years.

But as for the surgery itself. Piece of cake. After discussion with the surgeon I chose mono vision also, and have had zero problems. I was just at the optometrist this Thursday. He said my vision is still great, which I knew.

We have a neighbor that recently had both eyes done. She is very squeamish, and could not do the pre or post op drops herself. So several of us in the neighborhood took turns daily for the past several weeks administering her drops.

For those that are apprehensive about having cataracts removed. I would suggest you not be.
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Old 09-16-2023, 06:18 PM   #10
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Thanks so very much for your detailed report. The doctors should give something like this write-up to all patients before the procedure.
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Old 09-16-2023, 06:53 PM   #11
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One concern I had about monovision without glasses was how it would affect the Ohio BMV (Bureau of Motor Vehicles) eye test at each driver license renewal. Information was sorely lacking online so I did an online query, never expecting a response.

I was completely shocked when my cell phone rang days later and it was a person from the state BMV office in Columbus, OH. I mean really, really shocked.

She asked me to explain my concern to assure she understood it. I explained that I have natural monovision but with glasses it's corrected and I was going to monovision during cataract surgery and hopefully be without glasses.. She understood.

She said not to confuse "monocular" and "monovision". "Monocular" means one eye is 20/200 or worse corrected. Otherwise the standards for binocular vision are used. "Binocular" simply means both eyes are better than 20/200 corrected or uncorrected.

She said that monovision is not an issue and the local BMV will test without glasses and each eye separately. Then they would test with both eyes open.

She explained the vision requirements and if I have both eyes corrected to 20/200 or better with cataract surgery it is considered "binocular". As long as both eyes together meets 20/40 I can have a license without glasses. Between 20/41 and 20/70 corrective lenses will be required.

If I truly had monocular vision, such as with the total loss of one eye, the numbers are 20/30 and 20/60 instead.

The standards are slightly tighter for a CDL or bus driver.

Yet another concern alleviated.

Other states may have different rules, of course.

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Old 09-16-2023, 07:07 PM   #12
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Everyone has written wonderful descriptions that I can identify with. Been there, done that 2X.

What I didn’t catch was the option to upgraded lenses. In my case I chose Panoptix which have three focal points and of course they are $$$ beyond our insurance coverage because it’s an “upgrade”. IMHO, the investment to not need glasses was huge.
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Old 09-16-2023, 07:21 PM   #13
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Thanks for sharing your experiences Ray. I’ve been told this is in my future too. At 68, I’m gonna hold out as long as I can. Not bad yet but they’re there.
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Old 09-16-2023, 07:27 PM   #14
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Originally Posted by WDW View Post
Everyone has written wonderful descriptions that I can identify with. Been there, done that 2X.

What I didn’t catch was the option to upgraded lenses. In my case I chose Panoptix which have three focal points and of course they are $$$ beyond our insurance coverage because it’s an “upgrade”. IMHO, the investment to not need glasses was huge.
Hope it worked for you. Of course, I was given the pitch for them, but when I read about no guarantees for all people I decided to stay with my lifelong eye protectors, my glasses. Laser surgery was another option I was offered. So was formulated eye drops at yet another out of pocket expense. For two years I had been diagnosed with Left 4th Cranial Nerve Palsy. And all the while was told that cataracts were going to need addressing at some point. I had brain scans and was tested for MG and there was no direct reason for my Diplopia. So I got a second opinion. No, I did not have Diplopia, I had bad cataracts which were causing the double vision. Sheesh!
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